UPMC’s telemedicine service has suffered a setback in its plans to expand into West Virginia.
The West Virginia Health Care Authority turned down a request by UPMC AnywhereCare to operate in all 55 counties of the state. Pittsburgh-based UPMC had applied for a certificate of need to offer telemedicine service in West Virginia in June 2015 and the authority rejected the request May 9.
The authority found that UPMC had not justified the need for the service; was not the most cost-effective option for residents seeking medical care; and did not address the specific primary care needs in West Virginia, according to the ruling.
Pittsburgh-based health insurer and medical provider Highmark were among the opponents to the UPMC plan, arguing that UPMC would cherry-pick patients, leaving indigent patients to West Virginia’s doctors and hospitals.
“The authority is concerned that a direct-to-consumer telemedicine service is necessarily episodic and adjunctive in nature, and is therefore limited in its effectiveness as a primary care delivery option,” the authority ruled. Telemedicine is a video conferencing link between a doctor or other healthcare professional and a patient.
UPMC AnywhereCare was started in November 2013 in Pennsylvania, offering patients medical advice on a range of minor health problems for a $38 fee. It is not covered by health insurance.
In June 2015, UPMC expanded the service to Maryland.
In West Virginia, UPMC anticipated 10,164 virtual patient visits in 2016, increasing 33 percent to 13,500 visits by 2018 and revenue reaching $513,010 from $386,213 during the same period, both up 33 percent, according to authority documents.
UPMC has until June 9 to appeal the authority’s decision. A UPMC spokesperson was not immediately available.
Date: 3 June, 2016